Safety and Efficacy of High-Dose Daily Vitamin D3 Supplementation in Children and Young Adults Infected With Human Immunodeficiency Virus
J Ped Infect Dis (2014) doi: 10.1093/jpids/piu012
Kelly A. Dougherty1⇑, Joan I. Schall2, Babette S. Zemel1, Florin Tuluc3, Xiaoling Hou4, Richard M. Rutstein5 and Virginia A. Stallings1
1Division of Gastroenterology, Hepatology, and Nutrition, University of Pennsylvania Perelman School of Medicine, Children's Hospital of Philadelphia, Pennsylvania
2Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Pennsylvania
3Division of Allergy/Immunology, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Children's Hospital of Philadelphia, Pennsylvania
4University of Pennsylvania Perelman School of Medicine, Center for Clinical Epidemiology and Biostatistics, Biostatistics Analysis Center, Philadelphia, Pennsylvania
5Division of General Pediatrics, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Children's Hospital of Philadelphia, Pennsylvania
Corresponding Author: Kelly A. Dougherty, PhD, Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Children's Hospital of Philadelphia, 3535 Market Street, Room 1585, Philadelphia, PA 19104. E-mail: doughertyk at email.chop.edu.
Received August 20, 2013. Revision received January 7, 2014. Accepted January 13, 2014.
Background Suboptimal vitamin D (vitD) status is common in children and young adults infected with human immunodeficiency virus (HIV). The vitD supplemental dose needed to normalize vitD status in this population is unknown.
Methods In this double-blind trial, subjects infected with HIV ages 8.3 to 24.9 years were randomized to vitD3 supplementation of 4000 IU/day or 7000 IU/day and evaluated at 6 and 12 week for changes in vitD status and HIV indicators. A dose was considered unsafe if serum calcium was elevated (above age and sex-specific range) associated with elevated serum 25 hydroxyvitamin D (25(OH)D); >160 ng/mL).
Results At baseline, 95% of subjects (n = 44; 43% with perinatally acquired HIV, 57% with behaviorally acquired HIV) had a suboptimal serum 25(OH)D concentration of <32 ng/mL (mean ± standard deviation, 19.3 ± 7.4; range, 4.4–33.6 ng/mL). After 12 weeks (main outcome) of D3 supplementation, both D3 doses were safe and well tolerated, with no evidence of elevation of serum calcium concentrations or deterioration in HIV immunologic or virologic status. Sufficient vitD status, defined as serum 25(OH)D ≥32 ng/mL, was achieved in 81% of all subjects, and only the 7000 IU/day group (86%) achieved this a priori efficacy criterion in >80% of subjects. Change in serum 25(OH)D did not differ between HIV acquisition groups.
Conclusions A 7000 IU/day D3 supplementation was safe and effective in children and young adults infected with HIV.
Restore vitamin D levels in youths with HIV
Before: 95% < 32 ng
During: 7000 IU of vitamin D daily for 12 weeks
After: 86% > 32 ng (none > 160 ng)
The body consumes vitamin D in fighting many diseases.
It is virtually always good to restore vitamin D to a healthy level.
While the body is still fighting a disease a large amount of vitamin D will continue to be needed ( probably > 5,000 IU)
Restoration of vitamin D can easily happen about 3X faster if a restoration/loading dose of vitamin D is given
Perhaps 20,000 IU of vitamin D a day for a month
- Overview HIV and vitamin D
- Those with HIV who doubled their vitamin D levels reduced their chance of death by 47 percent – Oct 2013
- Blacks with HIV were 3.5X more likely to be vitamin D deficient than whites – May 2012
- All items in category HIV and Vitamin D
- Question – I have a health problem associated with low vitamin D – should I take Vitamin D
- HIV children in UK – Vitamin D recommendations – Feb 2014
- Treatment of HIV in youths helped by 7,000 IU of vitamin D – RCT July 2014 same 7,000 IU, but for an entire year